South Dakota TB Elimination Plan

The following plan was written in 1995 and endorsed by the SD TB Elimination Advisory Committee. It is used by the South Dakota TB Control Program to provide guidance and direction regarding program activities.

National TB Elimination Goal

By the year 2015, reduce tuberculosis to an incidence of no more than 1 case per million population.

South Dakota TB Elimination Goals

By the year 2015, reduce tuberculosis to an incidence of no more than 3.5 cases per 100,000 population.

Special population target: Native American 2015 Target = <15 cases per 100,000 population.

South Dakota Department of Health TB Control Efforts

A. Surveillance and Epidemiology

The cornerstone of tuberculosis control is the ability to collect statistical information and to conduct analysis of tuberculosis morbidity data. This is necessary so the program can determine which groups are at higher risk for tuberculosis disease and infection and identify geographic areas that consistently report higher rates of TB disease. This data analysis should be ongoing so as to identify any changes in the epidemiology of tuberculosis in South Dakota. This information then must be used to determine the TB Control Program activities.

B. Laboratory Services

The Tuberculosis Control Program will ensure that complete diagnostic laboratory services for tuberculosis area provided free of charge through the South Dakota State Public Health Laboratory (TB Laboratory Services) in Pierre. All M. tuberculosis isolates from South Dakota patients isolated in other laboratories must be forwarded to the State Public Health Laboratory to ensure that statewide surveillance for drug resistant M. tuberculosis is conducted in a systematic manner. If not performed at the State Public Health Laboratory, testing for Mycobacterium must be performed by or referred to a CAP/CLIA accredited laboratory approved for testing Mycobacteriology. This will ensure that all persons within South Dakota suspected or found to have tuberculosis shall have equal opportunity to accredited diagnostic services for the ultimate prevention, control and treatment of tuberculosis. Laboratories accepting specimens for M. tuberculosis testing will be requested to fully cooperate with data gathering and progress of cultures within the South Dakota Department of Health.

C. TB Control Program Activities

The Tuberculosis Control Program must direct limited resources towards the higher risk groups and the geographic areas identified so as to appropriately intervene in disease transmission (TB Program Services). Listed below are the current activities that compose the TB Control Program in South Dakota:

Central/administrative Office in Pierre

Write a federal grant to obtain partial funding for the program.

Provide complete diagnostic laboratory services and drug susceptibility studies free of charge for all persons suspected of having tuberculosis.

Provide up-to-date treatment literature and educational information for health-care providers on the treatment, diagnosis and control of TB.

Provide and maintain clinical TB services in Sioux Falls.

Contract with physicians to provide TB clinic and evaluation of patients.

Provide monthly monitoring of patients for medication side effects and compliance.

Offer HIV testing to patients with active TB and latent TB infection.

Provide education of patients and health care providers.

Non-Department Of Health Tuberculosis Elimination Efforts

A. South Dakota Tuberculosis Elimination Committee

By utilizing epidemiology and focusing on TB Control Program activities, we will be able to determine where we need to go to achieve our goal of TB elimination and discontinue activities that are non-productive and are of limited use. The SD TB Elimination Advisory Committee assists in this effort by providing the following:

Assist the TB Control Program in setting priorities, activities and identifying populations at risk for TB.

Assist in determining which activities to discontinue.

Work outside the formal committee to promote the goals of the TB Elimination Advisory Committee in South Dakota.

Increase resources for TB elimination activities.

B. Networking with Community Groups

Collaborate with community groups who are partners in TB elimination. Continue to work to identify and involve others who represent groups and individuals at risk for TB. Current SD partners in TB control are the American Lung Association of South Dakota, Indian Health Service, Tribal Health Boards, USD School of Medicine, Lutheran Social Services, Falls Community Health Center and the South Dakota Public Health Association.

Summary

Tuberculosis elimination in South Dakota is a possibility through a coordinated effort and a lot of hard work. The key is in continuing to identify the populations at risk and then dedicating appropriate resources towards this effort. By ensuring that limited resources are being directed at higher-risk populations and that non-productive activities are eliminated, we will be able to achieve our goal of tuberculosis elimination in South Dakota.